Langiulli Michael, Salomon Pierre, Aronow Wilbert S, McClung John A, Belkin Robert N
Department of Medicine, Cardiology Division, Westchester Medical Center/New York Medical College, Valhalla, NY 10595, USA.
Cardiol Rev. 2005 Nov-Dec;13(6):271-3. doi: 10.1097/01.crd.0000137252.53964.ae.
We investigated in-hospital and long-term mortality in 16 patients with infective endocarditis and paravalvular abscess on a prosthetic valve (6 of whom underwent surgery) and in 12 patients with infective endocarditis and paravalvular abscess on a native valve (8 of whom underwent surgery). The only significant risk factor for in-hospital mortality in patients with prosthetic or native value paravalvular abscess was age (P < 0.001). In-hospital mortality was 33% in patients with prosthetic valve paravalvular abscess undergoing surgery and 33% in patients treated medically (P = not significant). In-hospital mortality was 25% in patients with native valve paravalvular abscess undergoing surgery and 25% in patients treated medically (P = not significant). At 4.8-year follow up, survival of patients with prosthetic valve paravalvular abscess was 67% for patients treated surgically versus 40% for patients treated medically (P = not significant). At 4.8-year follow up, survival of patients with native valve paravalvular abscess was 75% for patients treated surgically versus 50% for patients treated medically (P = not significant).
我们调查了16例人工瓣膜合并瓣周脓肿的感染性心内膜炎患者（其中6例接受了手术）以及12例天然瓣膜合并瓣周脓肿的感染性心内膜炎患者（其中8例接受了手术）的院内死亡率和长期死亡率。人工瓣膜或天然瓣膜瓣周脓肿患者院内死亡的唯一显著危险因素是年龄（P < 0.001）。接受手术的人工瓣膜瓣周脓肿患者的院内死亡率为33%，接受药物治疗的患者为33%（P无统计学意义）。接受手术的天然瓣膜瓣周脓肿患者的院内死亡率为25%，接受药物治疗的患者为25%（P无统计学意义）。在4.8年的随访中，接受手术治疗的人工瓣膜瓣周脓肿患者的生存率为67%，接受药物治疗的患者为40%（P无统计学意义）。在4.8年的随访中，接受手术治疗的天然瓣膜瓣周脓肿患者的生存率为75%，接受药物治疗的患者为50%（P无统计学意义）。
